title: Gender differences in cardiovascular mortality by C-reactive protein level in the United States: evidence from the National Health and Nutrition Examination Survey III.
abstract: BACKGROUND
  The association between C-reactive protein (CRP) and cardiovascular (CV) mortality by gender has not been previously described using a data set that is representative of the US population.
  
  
  METHODS
  We used Cox proportional hazards models to explore gender differences in CRP-associated mortality via the National Health and Nutrition Examination Survey III 1988-1994 linked to the National Death Index with mortality follow-up through 2006. We examined CV mortality as well as all-cause mortality hazards.
  
  
  RESULTS
  The final sample size included a total of 13,878 individuals (7,364 women and 6,514 men) with a median follow up of 18.2 years. All models controlled for race, age, smoking, high-density lipoprotein, hypertension, diabetes mellitus, waist circumference, and total cholesterol. Men with a CRP >3.0 mg/L relative to those with a CRP ≤3.0 mg/L had elevated CV mortality hazards (hazard ratio [HR] 1.79, 95% CI 1.23-2.60) and all-cause mortality hazards (HR 1.57, 95% CI 1.29-1.90). In women, elevated CRP was not significantly associated with either increased CV (HR 1.20, 95% CI 0.90-1.59) or all-cause mortality hazards (HR 1.09, CI 0.93-1.29).
  
  
  CONCLUSIONS
  National guidelines from various agencies that make recommendations on the diagnostic and prognostic use of CRP have treated men and women equally. We find that there may be reason to tailor recommendations based upon one's gender.
authors.affiliation: New York University Langone Medical Center, New York, NY, USA. Bethany.Doran@nyumc.org
authors.forename: Bethany
authors.initials: B
authors.lastname: Doran
authors.forename: Wenyi
authors.initials: W
authors.lastname: Zhu
authors.forename: Peter
authors.initials: P
authors.lastname: Muennig
mesh_terms: D000328:Adult; D002097:C-Reactive Protein / Q000378:metabolism*; D002318:Cardiovascular Diseases / Q000097:blood / Q000401:mortality*; D002423:Cause of Death / Q000639:trends; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009749:Nutrition Surveys; D011379:Prognosis; D016016:Proportional Hazards Models; D017678:Sex Distribution; D012737:Sex Factors; D015996:Survival Rate / Q000639:trends; D014481:United States / Q000453:epidemiology
chemical_list: D002097:C-Reactive Protein